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Manufacturers: Akrikhin
Active ingredients
- Acyclovir
Disease class
- Immunodeficiency, unspecified
- Anogenital herpetic viral infection
- Other and unspecified infectious diseases
- Cytomegalovirus disease
- Disease caused by HIV with manifestations of other viral infections
- Herpes simplex virus infections
- Herpetic gingivostomatitis and pharyngotonsillitis
- Herpetic eye disease
- Chicken pox [varicella]
- Shingles
Clinical and pharmacological group
- Not indicated. See instructions
Pharmacological action
- Antiviral
Pharmacological group
- Antiviral (except HIV) drugs
Aciclovir-Akri oral tablets
Instructions for medical use of the drug
Description of pharmacological action
Penetrates into virus-infected cells, competitively interacts with viral thymidine kinase and is sequentially phosphorylated to form mono-, di- and triphosphate. Acyclovir triphosphate is integrated into the viral DNA chain, competitively inhibits the viral DNA polymerase and suppresses its replication.
Indications for use
Infections of the skin and mucous membranes caused by the herpes simplex virus (types 1, 2), including primary and recurrent genital herpes, and the herpes zoster virus; prevention of infections of the skin and mucous membranes in patients with reduced immunity.
Release form
tablets 200 or 400 mg; contour packaging 10, cardboard pack 2; tablets 200 or 400 mg; dark glass jar (jar) 20, cardboard pack 1;
Pharmacodynamics
Prevents the formation of new rash elements, reduces the likelihood of skin dissemination and visceral complications, and accelerates the formation of crusts. Relieves pain in the acute phase of herpes zoster.
Pharmacokinetics
Absorbed in the gastrointestinal tract by 20%. Relatively weakly binds to plasma proteins. The concentration in the cerebrospinal fluid is 50% of the plasma level. During biotransformation it forms 9-carboxymethoxymethylguanine. It is excreted in the urine unchanged and as a metabolite (10–15%). Average T1/2 - 3 hours.
Use during pregnancy
Contraindicated during pregnancy (passes the hematoplacental barrier). During treatment, you should stop breastfeeding (passes into breast milk).
Contraindications for use
Hypersensitivity.
Side effects
Rarely - nausea, vomiting, diarrhea, headache, increased fatigue, deterioration of hematological parameters, increased bilirubin content in plasma, increased activity of liver enzymes, allergic reactions.
Directions for use and doses
Inside; adults and children over 2 years old for the treatment of herpetic diseases - 0.2 g 5 times a day for 5 days; for immunodeficiency - a single dose is increased to 0.4 g. For the prevention of herpetic infections in patients with immunodeficiency - 0.2 g 4 times a day. Infections caused by the herpes zoster virus: 0.8 g 5 times a day for 7 days. Patients with impaired renal function need to adjust the dosage regimen: if creatinine Cl is less than 10 ml/min, the daily dose is reduced to 0.4 g in 2 divided doses with an interval between doses of at least 12 hours. In the treatment of infections caused by Varicella zoster and maintenance therapy of patients with a pronounced decrease in immunity and creatinine Cl 10–25 ml/min - 2.4 g/day in 3 divided doses with an interval of 8 hours. In patients with creatinine Cl less than 10 ml/min, the daily dose is reduced to 1.6 g in 2 divided doses with at intervals of 12 hours. Children under 2 years old - half the adult dose.
Interactions with other drugs
Probenecid slows excretion.
Precautions for use
Prescribe with caution to elderly patients and patients with severe renal impairment. It is necessary to ensure a regime of increased hydration of the body. Avoid getting the ointment on the mucous membranes of the mouth, nose, eyes, and vagina.
Storage conditions
In a dry place, protected from light, at a temperature not exceeding 25 °C.
Best before date
36 months
ATX classification:
J Antimicrobials for systemic use
J05 Antiviral drugs for systemic use
J05A Direct acting antivirals
J05AB Nucleosides and nucleotides
J05AB01 Aciclovir
Aciclovir-Akri ointment
Release form, composition and packaging
Ointment for external use 5% white or almost white with a characteristic odor.
1 year
acyclovir 50 mg.
Excipients: propylene glycol, medical petroleum jelly, petrolatum oil, polyethylene oxide, emulsifier.
Clinical and pharmacological group: Antiviral drug for external use.
pharmachologic effect
Antiviral. It has a highly selective effect on herpes simplex viruses type 1 and 2, herpes zoster, Epstein-Barr and cytomegalovirus. Easily passes through the corneal epithelium (eye ointment) and creates a therapeutic concentration in the ocular fluid.
When used topically in the form of a cream, it is not absorbed into the systemic circulation.
Penetrates through the BBB and placental barrier, excreted in breast milk.
In case of herpes, it prevents the formation of new rash elements, reduces the likelihood of skin dissemination and visceral complications, accelerates the formation of crusts, and reduces pain in the acute phase of herpes zoster.
Has an immunostimulating effect.
Indications
- primary and recurrent herpetic lesions of the skin and mucous membranes (including genital herpes), herpetic lesions in patients with immunodeficiency (treatment and prevention),
- herpes zoster,
- chicken pox,
- simple herpetic keratitis.
Dosage regimen
In case of infection of the skin and mucous membranes caused by the herpes simplex virus, cream or ointment (5%) is applied to the affected surface 5 times a day for 5-10 days
Side effect
Headache, fatigue, neurological disorders, shortness of breath, nausea, vomiting, diarrhea, intestinal colic, fever, edema, lymphadenopathy, increased levels of bilirubin, urea, creatinine, transient increase in the activity of liver transaminases, allergic reactions in the form of skin rash, itching.
With intravenous administration - agitation, impaired consciousness, lethargy, tremor, convulsions, hallucinations, psychosis, coma; reactions at the IV injection site - local inflammation, phlebitis.
When used externally - erythema, peeling, burning sensation, burn.
Contraindications
- hypersensitivity,
- breast-feeding
Pregnancy and lactation
The drug is contraindicated during breastfeeding.
special instructions
To prevent crystallization in the tubular apparatus, it is recommended to take large amounts of liquid.
Caution should be exercised in patients with psychoneurotic disorders, impaired renal and liver function, electrolyte disturbances, and severe hypoxia.
It is recommended to apply the cream using rubber gloves to prevent infection of other areas of the skin.
Overdose
Symptoms: headache, neurological disorders, shortness of breath, nausea, vomiting, diarrhea, renal failure, lethargy, convulsions, coma.
Treatment: maintenance of vital functions, hemodialysis.
Drug interactions
Probenecid slows down excretion (blocks tubular secretion
Storage conditions and periods
Store at 8–25 °C.
Shelf life: 3 years.
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** The Drug Directory is intended for informational purposes only. For more complete information, please refer to the manufacturer's instructions. Do not self-medicate; Before starting to use the drug Acyclovir-Acri, you should consult a doctor. EUROLAB is not responsible for the consequences caused by the use of information posted on the portal. Any information on the site does not replace medical advice and cannot serve as a guarantee of the positive effect of the drug.
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Aciclovir-Akri
Release form, composition and packaging
Blue tablets with dark and light blue inclusions and possible white spots, flat-cylindrical, with a chamfer and a score.
1 tab.
acyclovir 200 mg.
-“- 400 mg.
Excipients: microcrystalline cellulose, polyvinylpyrrolidone, indigo carmine, magnesium stearate, sodium starch glycolate, purified water.
Clinical and pharmacological group: Antiviral drug.
pharmachologic effect
The antiviral drug is a synthetic analogue of thymidine nucleoside. In infected cells containing viral thymidine kinase, phosphorylation occurs and is converted to acyclovir monophosphate. Under the influence of acyclovir guanylate cyclase, monophosphate is converted into diphosphate and, under the action of several cellular enzymes, into triphosphate.
High selectivity of action and low toxicity to humans are due to the absence of the necessary enzyme for the formation of acyclovir triphosphate in intact cells of the macroorganism. Acyclovir triphosphate, “incorporating” into the DNA synthesized by the virus, blocks the reproduction of the virus. The specificity and very high selectivity of the action are also due to its predominant accumulation in cells affected by the herpes virus.
Highly active against Herpes simplex virus types 1 and 2; the virus that causes chickenpox and herpes zoster (Varicella zoster); Epstein-Barr virus (types of viruses are indicated in increasing order of the MIC value of acyclovir).
Moderately active against CMV. In case of herpes, it prevents the formation of new rash elements, reduces the likelihood of skin dissemination and visceral complications, accelerates the formation of crusts, and reduces pain in the acute phase of herpes zoster.
Has an immunostimulating effect.
Indications
- treatment of primary and recurrent severe genital herpes (including in patients with impaired immunity)
- prevention of frequently recurrent (6 or more cases per year) genital herpes (including in patients with impaired immunity)
- treatment of primary and recurrent herpes simplex with damage to the skin and mucous membranes, caused by the Herpes simplex virus types 1 and 2, in patients with impaired immunity
- prevention of herpes simplex in patients with impaired immunity (including after transplantation and taking immunosuppressive drugs, HIV-infected patients, during chemotherapy)
- encephalitis caused by the Herpes simplex virus types 1 and 2 - parenterally,
- treatment of herpes zoster caused by the Varicella zoster virus in adults
- in patients with impaired immunity and with generalized herpes zoster in patients with unimpaired immunity
- prevention of herpes zoster caused by the Varicella zoster virus, after the initial period of using acyclovir for parenteral use in all patients with impaired immunity (including after transplantation and when taking immunosuppressive drugs, HIV-infected patients, during chemotherapy)
- herpes zoster affecting the eyes
- generalized infection in newborns caused by the Herpes simplex virus
- chickenpox in patients with unimpaired immunity within 24 hours after the appearance of a typical rash - orally, in patients with impaired immunity.
Dosage regimen
Inside, intravenously.
To prevent relapses of Herpes simplex, patients with immunodeficiency are prescribed 200 mg 4 times a day every 6 hours.
In case of severe immunodeficiency (after bone marrow transplantation or in case of impaired absorption from the intestine) - 400 mg 5 times a day.
Children over 6 years old - 800 mg 4 times a day; 2-6 years - 400 mg 4 times a day; under 2 years - 200 mg 4 times a day.
More accurately, the dose can be determined at the rate of 20 mg/kg, but not more than 800 mg 4 times a day.
The course of treatment is 5 days.
For children from 3 months to 12 years, the dose for intravenous administration is determined based on body area: infections caused by the Herpes simplex virus - 250 mg/sq.m of body surface every 8 hours; reduced immunity, herpetic encephalitis, chickenpox, herpes zoster - 500 mg/sq.m.
Inside.
Genital herpes: initial therapy - 200 mg every 4 hours while awake, 5 times a day for 10 days; recurrent genital herpes (less than 6 episodes per year), intermittent therapy - 200 mg every 4 hours while awake, 5 times a day for 5 days; recurrent genital herpes (more than 6 episodes per year), long-term suppressive therapy - 400 mg 2 times a day or 200 mg 3-5 times a day.
Herpes simplex of the skin and mucous membranes (treatment): 200-400 mg 5 times a day for 10 days in patients with impaired immunity.
Herpes simplex of the skin and mucous membranes (prevention): 400 mg every 12 hours. Herpes zoster: 800 mg every 4 hours while awake, 5 times a day for 7-10 days. Chicken pox: 800 mg 4 times a day for 5 days.
Treatment should begin at the earliest signs or symptoms of chickenpox.
For chronic renal failure, dose adjustment is necessary depending on the size of the CK and the required dosing regimen for normal renal function: normal renal function and chronic renal failure with CK more than 10 ml/min - 200 mg every 4 hours, 5 times a day CK less than 10 ml/min - 200 mg every 12 hours; normal renal function, chronic renal failure with creatinine clearance more than 10 ml/min - 400 mg every 12 hours, with creatinine clearance less than 10 ml/min - 200 mg every 12 hours; normal renal function, chronic renal failure with CK more than 25 ml/min - 800 mg every 4 hours while awake, 5 times a day, CK 10-25 ml/min - 800 mg every 8 hours, CK less than 10 ml/min - 800 mg every 12 hours
Children under 2 years of age - the dose has not been determined. However, when studying the drug, no unusual toxic effects or specific pediatric problems were identified in children receiving acyclovir in doses of up to 3 g/m2 and 80 mg/kg per day.
Children 2-12 years old, weighing up to 40 kg, with chickenpox: orally, 20 mg/kg, up to 800 mg per dose, 4 times a day for 5 days. Children 2-12 years old, weighing 40 kg or more, with chickenpox: adult dose. IV drip (administered at a constant rate for at least 1 hour).
Severe genital herpes, initial therapy: adults and children over 12 years of age - 5 mg/kg every 8 hours for 5 days; children under 12 years old - 250 mg/sq.m every 8 hours for 5 days.
Herpes simplex of the skin and mucous membranes in patients with impaired immunity: adults and children over 12 years old - 5-10 mg/kg every 8 hours for 7 days; children under 12 years old - 250 mg/sq.m every 8 hours for 7 days.
Encephalitis caused by the Herpes simplex virus: adults and children over 12 years of age - 10 mg/kg every 8 hours for 10 days; children from 3 months to 12 years - 20 mg/kg every 8 hours for 10 days.
Herpes zoster in patients with impaired immunity: adults and children over 12 years of age - 10 mg/kg every 8 hours for 7 days; children under 12 years of age - 20 mg/kg every 8 hours for 7 days.
Generalized infection in newborns caused by the Herpes simplex virus: newborns and children under 3 months - 10 mg/kg every 8 hours for 10 days. A dose of 15-20 mg/kg every 8 hours can be used, but the effectiveness and safety of such doses have not been established. For chronic renal failure in adults and children, a dose reduction and/or change in the interval between administration is required: CC more than 50 ml/min, dose - 100%, interval - 8 hours; CC 25-50 ml/min, dose - 100%, interval - 12 hours; CC 10-25 ml/min, dose - 100%, interval - 24 hours; CC less than 10 ml/min, dose - 50%, interval - 24 hours.
The maximum dose for adults when administered intravenously is 30 mg/kg or 1.5 g/m2/day.
Side effect
Anaphylactic reactions, allergic skin reactions (itching, rash, Lyell's syndrome, urticaria, exudative erythema multiforme, including Stevens-Johnson syndrome), confusion, increased activity of liver transaminases, fever, hallucinations, leukopenia, lymphadenopathy, peripheral swelling, blurred vision, headache. For parenteral administration only: phlebitis or inflammation at the injection site, acute renal failure, signs of encephalopathy (coma, confusion, hallucinations, seizures, tremors), hematological disorders (anemia, leukocytosis, neutropenia or neutrophilia, thrombocytopenia or thrombocytosis), hematuria, DIC -syndrome, hemolysis, decreased blood pressure, mental disorders (including delirium), depression or psychosis, gastrointestinal dysfunction (decreased appetite, nausea, vomiting), increased urea nitrogen and hypercreatininemia (due to renal tubular obstruction; usually with the correct dose and adequate fluid intake, no increase is observed). When taken orally only: malaise, gastrointestinal dysfunction (nausea, vomiting, diarrhea, abdominal pain), agitation, alopecia, dizziness, myalgia, paresthesia, drowsiness.
Contraindications
- hypersensitivity (including to valacyclovir).
With caution. Pregnancy, lactation period.
For intravenous administration (additionally) - renal failure (risk of nephrotoxicity), dehydration, neurological disorders or neurological reactions to taking cytotoxic drugs (including a history of
Pregnancy and lactation
The drug should be used with caution.
special instructions
Long-term or repeated treatment with acyclovir in patients with reduced immunity can lead to the emergence of strains of viruses that are insensitive to its action.
Most isolated strains of viruses that are insensitive to acyclovir show a relative lack of viral thymidine kinase; strains with altered thymidine kinase or with altered DNA polymerase were isolated. In vitro, the effect of acyclovir on isolated strains of the Herpes simplex virus may cause the emergence of less sensitive strains.
